Basic Information
| Provider Information | |||||||||
| NPI: | 1851624027 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH TEXAS STROKE CENTER, PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | DBA TEXAS STROKE INSTITUTE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 COIT RD | ||||||||
| Address2: | SUITE #104 | ||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725665411 | ||||||||
| FaxNumber: | 9725198337 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 COIT RD | ||||||||
| Address2: | SUITE #104 | ||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725665411 | ||||||||
| FaxNumber: | 9725198337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2009 | ||||||||
| LastUpdateDate: | 01/28/2015 | ||||||||
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| AuthorizedOfficialLastName: | SMITHAM | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9724019807 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.